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All of the following are true about specific functions of the gut EXCEPT:

A. Gastric acid sterilizes the upper gut.

B. Most nutrient absorption occurs in the small intestine.

C. The pancreas secretes bicarbonate, which optimizes the pH in the intestine for enzyme activation.

D. The stomach secretes intrinsic factor which is necessary for vitamin B12 absorption.

E. The terminal ileum is primarily responsible for stool dehydration, decreasing volumes from 1000–1500 mL to 100–200mL.

The answer is E. (Chap. 314) The colon is primarily responsible for stool dehydration, decreasing volumes from 1000–1500 mL to 100–200 mL. The stomach triturates and mixes the food bolus with pepsin and acid. The stomach also secretes intrinsic factor, which is necessary for vitamin B12 absorption. Gastric acid sterilizes the upper gut. Pancreatic juice contains enzymes for carbohydrate, protein, and fat digestion as well as bicarbonate to optimize the pH for enzyme activation.

All of the following diseases are associated with gastric acid hypersecretion EXCEPT:

A. Duodenal ulcers

B. G-cell hyperplasia

C. Pernicious anemia

D. Retained antrum syndrome

E. Zollinger-Ellison syndrome

The answer is C. (Chap. 314) Pernicious anemia is associated with little or no gastric acid due to a lack of intrinsic factor. This is caused by autoantibodies that damage the gastric parietal cells. Gastrin G-cell hyperplasia results in increased gastrin levels, which leads to gastric acid hypersecretion. About 50% of G-cell hyperplasia is related to Helicobacter pylori infection and can be treated with eradication of the bacterium. Retained antrum syndrome is a rare postgastrectomy syndrome following a Billroth-II procedure in which the antrum has not been entirely removed. Some patients with duodenal ulcers have acid hypersecretion. Zollinger-Ellison syndrome is caused by a tumor (usually in the pancreas or duodenum) that secretes gastrin and therefore causes gastric acid hypersecretion.

Which of the following gastrointestinal conditions is characterized by noninflammatory visceral pain?

A. Appendicitis

B. Cholecystitis

C. Inflammatory bowel disease

D. Mesenteric ischemia

E. Peptic ulcer

The answer is D. (Chap. 314) Mesenteric ischemia, biliary colic, and neoplasms most commonly cause noninflammatory visceral pain. Peptic ulcer, appendicitis, diverticulitis, inflammatory bowel disease, ...

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